PhD/PsyD From Psychotherapy to Assessment/Testing

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hum1

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Hello,

I have been doing psychotherapy for the past 20 something years and am in need of a career change. I also teach for a PsyD program during the Summer and I really enjoy it. However, I would not want to leave my clinical practice to become a full time adjunct and have a precarious and highly unstable job situation.

I thought about starting to do some psychological assessment/testing and am wondering what first steps I would need to take? In the past I have applied some tests such as the MMPI, WAIS, WISC, BDI, TAT, etc. however I did not do my internship nor my post doc in assessment. I thought about applying some of the aforementioned tests, do autism evaluations, or do simple court evaluations, etc. but would not want to do more complex evaluations such as e.g. neuro psych evaluations.

I am aware that applying tests and writing reports is an extremely difficult and very specialized task, however I was wondering if it would be possible to do a career change without having to go back in training an do an internship and post doc in testing? If so, which steps should I take? Is there training, supervision? Thank you for your thoughts.

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What do you mean by "simple court evaluations?"
In the state where I live, Massachusetts, there are clinicians who do immigration evaluations for attorneys. I meant a diverse group of legal evaluations and reports, not forensic evaluations.
 
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I'm confused. How are "legal evaluations" not forensic evaluations? How are you defining and operationalizing these terms to differentiate them?
 
I'm confused. How are "legal evaluations" not forensic evaluations? How are you defining and operationalizing these terms to differentiate them?
I am sorry, I know very little of forensic and legal assessment. The point I was trying to make is that I believe that psychologists that conduct neuropsych and forensic assessments start this route in their practicum/internship/post docs, therefore I would exclude pursuing such assessments.
 
Hello,

I have been doing psychotherapy for the past 20 something years and am in need of a career change. I also teach for a PsyD program during the Summer and I really enjoy it. However, I would not want to leave my clinical practice to become a full time adjunct and have a precarious and highly unstable job situation.

I thought about starting to do some psychological assessment/testing and am wondering what first steps I would need to take? In the past I have applied some tests such as the MMPI, WAIS, WISC, BDI, TAT, etc. however I did not do my internship nor my post doc in assessment. I thought about applying some of the aforementioned tests, do autism evaluations, or do simple court evaluations, etc. but would not want to do more complex evaluations such as e.g. neuro psych evaluations.

I am aware that applying tests and writing reports is an extremely difficult and very specialized task, however I was wondering if it would be possible to do a career change without having to go back in training an do an internship and post doc in testing? If so, which steps should I take? Is there training, supervision? Thank you for your thoughts.
First, I don't think it'd be possible to go back and do an internship, at least via the APPIC route. A formal or informal postdoc is possible, but it'd likely be full-time and you'd probably take a pay cut. Peer-to-peer consultation (combined with self-study) is typically how folks go about expanding their competence once they're already practicing.

Beyond that, it's all going to depend on what types of assessments you're wanting to provide, which will probably be dependent in (large) part on what's in-demand in your area.

If it's been a while since you've done any type of assessment, which it sounds like is the case, I'd stay away from anything court-related, at least initially. When you want to start dipping your toes into that, you're going to need peer-to-peer consultation/supervision at the very least. Ideally, you'd conduct evaluations in partnership with another psychologist, maybe even observe a couple done by them to start. I have no experience with immigration evaluations, so I can't speak to how simple they are. But it's a niche, and you'd need someone knowledgeable in that area, which includes not just knowledge of whatever assessments are appropriate, but of how to use and interpret those assessments in the context of the overall purpose of the eval.

From a clinical perspective, you're still going to want some peer-to-peer consultation. I'd start by selecting probably one type of assessment to gain experience with. Maybe ADHD evals, maybe adult autism evals, maybe broader psychological assessments based on referrals from a psychiatrist. Ideally something you have some prior training and experience with, and something someone else in the area is already doing and willing to consult with you on.
 
In our local area, psychologists have a 3 to 4 month waiting list for assessments. If I was looking to get some experience in assessment and get that aspect of my practice rolling again, I would reach out to a couple of them and offer to help with some of their backlog and in exchange for consultation and the referral, offer a 50/50 split.
 
In the state where I live, Massachusetts, there are clinicians who do immigration evaluations for attorneys. I meant a diverse group of legal evaluations and reports, not forensic evaluations.

What is an immigration evaluation? Seems like a potentially loaded area of practice these days
 
What is an immigration evaluation? Seems like a potentially loaded area of practice these days

I had a professor in grad school who specializes in interpersonal violence and child abuse. She did these often, usually for people applying for U-VISAs and the like. There may be other contexts, but that’s what I’m familiar with. I would agree that this may not be the best area to jump into given the current climate, especially if you are not well versed in the process already.
 
What is an immigration evaluation? Seems like a potentially loaded area of practice these days
I'm not familiar with them, but have seen requests for them come across my state psych listserv. I think they primarily speak to what effect immigrating (or rather, not immigrating) could have on the person, so as to potentially help their case to immigrate. Although I would suspect with the understanding that it, like other forensic evals, is independent and thus may not help their case.
 
A psychologist who I used work with did some of these and even specialized in it on internship and post doc. The context they did it in was asylum and other immigration applications for individuals who were in some subject to systemic discrimination or other oppression in their countries of origin. There were many people from South and Central America, SE Asia, the Middle East, and Africa who were subjected to trauma and violence by the government or other armed groups. Having an expertise in trauma and PTSD was really important, as was working with translators and cultural competence and humility. My understanding is that their psychological status is often inferred by the courts as a sign of the veracity of their concerns about being deported back to their country of origin. E.g., if they already have PTSD from systemic sexual violence perpetrated against members of their community by a different group in their country, then that's evidence that their concerns about being subjected to similar or new kinds of violence is well-founded and not a ploy to use this area of special immigration status to unlawfully immigrate to the US.

One of the problems with this area of work is that the financial aspects are wildly disparate. In this psychologist's specialty area, there's basically no money. The individuals being evaluated are destitute and therefore the evaluations are often paid for by some nonprofit or other NGO and it's a pittance, frequently relying on unpaid/low paid trainees to do a lot of the heavy lifting, as there are many individuals seeking these services. There seem to be a subset of the immigration evals that are well compensated, either because the the individual and/or their personal connections have money or if there is a well-funded group paying for it (often by expats and 2nd+ generation members of their own communities).
 
Immigration evaluations can be used to:
1) Allow access to U&T and Violence Against Women Visas (i.e., the applicant was the victim of one of the specifically enumerated crimes, which allows them a visa).
2) document "hardship", allowing them an exemption from the usual process of immigration or being removed from their family in the US,
3) Allow use of N-648 or naturalization waivers from the usual immigration process (e.g., you diagnose someone with a learning disorder, so maybe they can be exempt from the written civics test or English test).
 
In Massachusetts there are master level clinicians such as social workers and counselors doing all different types of evaluations: "Immigration Evaluations", "Mental Health Evaluation", etc. I think it is a difficult area to work at because master level clinicians usually charge lower fees than psychologists.
 
Hello,

I have been doing psychotherapy for the past 20 something years and am in need of a career change. I also teach for a PsyD program during the Summer and I really enjoy it. However, I would not want to leave my clinical practice to become a full time adjunct and have a precarious and highly unstable job situation.

I thought about starting to do some psychological assessment/testing and am wondering what first steps I would need to take? In the past I have applied some tests such as the MMPI, WAIS, WISC, BDI, TAT, etc. however I did not do my internship nor my post doc in assessment. I thought about applying some of the aforementioned tests, do autism evaluations, or do simple court evaluations, etc. but would not want to do more complex evaluations such as e.g. neuro psych evaluations.

I am aware that applying tests and writing reports is an extremely difficult and very specialized task, however I was wondering if it would be possible to do a career change without having to go back in training an do an internship and post doc in testing? If so, which steps should I take? Is there training, supervision? Thank you for your thoughts.
Probably wouldn't do any of this is, as most of these are somewhat specialized. ASD has been hot-topic for years now and appropriate dx has HUGE implications for tx/services, resource allocation, and can followed Pts for many years. And no court evaluation should be viewed as "simple" for similar reasons...and other reasons.

If it has been 20 years of mostly being a treating psychotherapy provider, you really need some specialized training and supervision if you want to switch to this. I don't know how one would go about this without sacrificing current work/hours? It's also likely to cost you money for a while too.
 
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Personally, I wouldn't touch the medicolegal world without the prerequisite experience and a mentor/senior colleague in the area willing to guide you somewhat. Lot of potential pitfalls for those naive to the games that go on in such evaluations. And, mistakes here can follow you for a long time.
 
Personally, I wouldn't touch the medicolegal world without the prerequisite experience and a mentor/senior colleague in the area willing to guide you somewhat. Lot of potential pitfalls for those naive to the games that go on in such evaluations. And, mistakes here can follow you for a long time.
Came in to basically write this.

Even for people who have a mentor and some prior exposure to medicolegal work, it can still have a steep learner curve. Too many things can go wrong bc many people don’t know what they don’t know.

Some of the least prepared “experts” are clinicians who want to do legal work “on the side”. They often will take on bad cases and that’s not good for their reputation. I purposefully am picky with cases I accept bc a bad case can follow you for years.
 
Thank you all for your thoughts. So after reading everybody's comments would it be fair for me to conclude that a change of career from psychotherapy to assessment would be a very difficult change? And that the change is almost as if I am changing to a complete different professional area? Moreover, this change would involve a lot of years of investment of time/training/money/supervision?

I take my professional work very seriously and am still supervised in my clinical work. However, I have been doing psychotherapy for a very long time, and am wondering for those who do psychotherapy if they do other jobs/tasks which involve less direct hours with clients/patients?
 
Thank you all for your thoughts. So after reading everybody's comments would it be fair for me to conclude that a change of career from psychotherapy to assessment would be a very difficult change? And that the change is almost as if I am changing to a complete different professional area? Moreover, this change would involve a lot of years of investment of time/training/money/supervision?

I take my professional work very seriously and am still supervised in my clinical work. However, I have been doing psychotherapy for a very long time, and am wondering for those who do psychotherapy if they do other jobs/tasks which involve less direct hours with clients/patients?
Why are you still being supervised after two decades in the field?

Getting consultation is one thing, but being "supervised" after so long seems a bit odd.
 
Why are you still being supervised after two decades in the field?

Getting consultation is one thing, but being "supervised" after so long seems a bit odd.

Why would it be odd? I believe that doing clinical work is something that we need to learn over and over again, that every psychotherapy process and client/patient are unique, so it is a lifelong learning process. So having a supervisor with whom I meet every week or every two weeks has been very helpful to discuss clinical cases. I also attend to seminars, courses, reading groups, where I see much older people, in their 50s, 60s, 70s, who also enjoy discussing clinical cases and learning from others.
 
Why would it be odd? I believe that doing clinical work is something that we need to learn over and over again, that every psychotherapy process and client/patient are unique, so it is a lifelong learning process. So having a supervisor with whom I meet every week or every two weeks has been very helpful to discuss clinical cases. I also attend to seminars, courses, reading groups, where I see much older people, in their 50s, 60s, 70s, who also enjoy discussing clinical cases and learning from others.
Because it is. As in its not a common practice. Who pays this supervisor?

And I think the literature strongly disagrees that every psychotherapy process is unique.
 
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